Making Medicaid Better Newsletter 7.15.2011

July 15, 2011

Key Announcements Made in Department's Consumer Engagement Strategy for Making Medicaid Better

The Department of Health announced this week that two critical contract awards have been made to further the state's efforts to build and sustain a robust consumer engagement strategy for Making Medicaid Better.

On July 11, LDH announced its intent to award the contract of Enrollment Broker to MAXIMUS Health Services Inc. This contract will provide support services and further the general welfare of Louisiana Medicaid eligible citizens through choice counseling, enrollment and disenrollment into Medicaid's Coordinated Care Network (CCN) Program and the Greater New Orleans Community Health Connection (GNOCHC) Patient Centered Medical Home (PCMH) Program, consistent with federal Medicaid and state requirements.

Deliverables include but are not limited to enrollment and re-enrollment into CCNs, proactive selection of CCNs by potential members, electronic exchange of enrollment data with the Medicaid Fiscal Intermediary (FI) as well as CCNs, processing disenrollment requests, maintaining call center services for members and potential members, CCN website and sampling provider practices to verify 24/7 access.

MAXIMUS Health Services Inc. won the contract after a competitive procurement process with the state was completed. The company was founded more than 30 years ago and is headquartered in Reston, Va. with more than 220 local offices around the world and more than 7,000 employees. MAXIMUS commits to having a local office in each of the communities it serves. MAXIMUS has extensive experience with Medicaid and CHIP programs across the country, including previous work for Louisiana when the MAXIMUS Center for Health Literacy worked on a program for LaCHIP to help promote the "Medical Home" concept to families.

On June 16, LDH announced its intent to award the contract to develop and conduct an education and outreach campaign to Wright Feigley Communications of Baton Rouge. This contract will engage CCN-eligible Medicaid and LaCHIP recipients to inform and educate them about the changes to Louisiana Medicaid and reinforce the importance of making a proactive choice of a CCN. This campaign will be developed and implemented in close consultation and coordination with the Department and Enrollment Broker, and will use a strong mix of traditional and non-traditional media, direct mail and aggressive one-on-one outreach events to reach the target audience.

The vendor will be responsible for development of all messaging, the development of ad creative and other collateral (including direct mail pieces, posters and other printed and digital material), training of Department staff and community-based organizations and planning of outreach events.

Wright Feigley Communications, which won the contract after a competitive procurement process with the state was completed, is a full-service marketing, advertising and public relations agency headquartered in Baton Rouge. The company has extensive experience with health and social services communications for the targeted audiences. Wright Feigley has partnered with Franklin Industries and SSA Consultants, both of Baton Rouge, on the education and outreach project. Franklin Industries will be working on the community outreach events, and SSA Consultants will assist with field testing the messages and materials being developed for efficacy.

"We have said from day one that this transformation about Medicaid is first and foremost about the people we serve," said LDH Secretary Bruce D. Greenstein. "That's why I am proud of our team's commitment to making sure we do everything in our power to reach all CCN-eligible Medicaid enrollees and ensure they are given all the information needed to make good choices for themselves and their families."

Additionally, as part of the larger consumer engagement strategy, the Department is developing a Request for Applications for a CCN Consumer Ombudsman, who will be available to help patients navigate the CCN system should they have concerns. That RFA is expected to be posted at www.MakingMedicaidBetter.com in the early part of August.

Featured Question

Can I treat patients in a CCN if I am not currently enrolled as a Medicaid provider?

This depends on which type of CCN a medical provider wishes to join. The CCN-Shared Savings model will still operate as Medicaid fee-for-service, with payments administered through the State's Fiscal Intermediary. Because of this, any provider who wishes to sign up with a CCN-Shared Savings network will need to enroll as a Medicaid provider. But, the CCN-Prepaid model will be administered through an

insurance company or similar entity, with payments handled directly through the network. Providers who wish to treat patients in this type of CCN can enroll directly with the entity administering that network and do not need to enroll with Medicaid. However, they still must be eligible to enroll in Medicaid.

Providers should keep in mind that they can sign up with as many CCNs as they wish, and can participate in both shared savings and prepaid networks. Providers also can enroll with Medicaid to treat patients who will not transition to the CCN model. This is important because while two-thirds of Louisiana Medicaid recipients will enroll with CCNs for their care, other recipients are not part of the initial CCN implementation and will remain on the current, strictly fee-for-service system.

LDH will announce the CCNs that are selected to offer care for Medicaid recipients July 25 and after that time, the networks will begin reaching out to providers to get contracts for medical services in place. Providers should refer to the "For Health Care Providers" section of the website www.MakingMedicaidBetter.com to see the requirements both CCN models must include in their contracts.

Updates for Providers

LDH Launches 39-Week Initiative to Improve Birth Outcomes

LDH Secretary Bruce D. Greenstein joined State Rep. Regina Barrow and other state health leaders at Woman's Hospital in Baton Rouge this week to announce a critical step in Louisiana's efforts to help healthier mothers deliver healthier babies.

The 39-Week initiative is a voluntary program, in which hospitals agree to adopt policies restricting non-medically necessary and elective deliveries before the 39th week of pregnancy. So far, 20 hospitals, including many of the state's main birthing centers, are participating. LDH will work with partners including the March of Dimes, Louisiana Hospital Association and Louisiana State Medical Society to conduct education and outreach with staff at other hospitals, making them aware of the health risks associated with early deliveries and encouraging them to adopt this initiative.

The 39-Week initiative is part of ongoing efforts to improve birth outcomes in Louisiana, which ranks poorly in rates of infant mortality, premature birth, low-birth weight and very low-birth weight babies. In November, the March of Dimes gave Louisiana an "F" for birth outcomes. Since then, LDH has been developing new methods to educate medical professionals and expectant mothers about the importance of receiving proper prenatal care and reducing elective deliveries.

"I was genuinely shocked to learn how many births were being done early that weren't medically necessary," Greenstein said. "Too many doctors and too many women just don't fully understand the risks, even in a healthy pregnancy. That's what makes the 39-Week Initiative so effective, as it brings the government and private sectors together toward a common goal that benefits everyone."

Medicaid pays for 70 percent of births in Louisiana, and pregnant women are among the first groups of recipients LDH will transition to the CCN model to better coordinate their care during pregnancy, labor and delivery.

To learn more about LDH's work to improve birth outcomes, and to see a list of hospitals participating in the 39-Week initiative, visit the department's website. A video of the press conference announcing the initiative is also available online.

Coordinated Care Network Resource Guide for Providers

LDH has issued a Coordinated Care Network Resource Guide for Providers, available online at www.MakingMedicaidBetter.com. This downloadable and printable guide, which can be accessed directly here, was created to address the most common questions providers have expressed about the state's proposal to transform Medicaid by implementing CCNs. Please review the guide, and visit www.MakingMedicaidBetter.com frequently to see the latest information and updates from the Medicaid program.